7.
AssessmentNursing History  Usual pattern of elimination, frequency and time of the day.  Normal routines followed to promote normal elimination.  Description of any recent change in elimination pattern.  Description of usual characteristics of stool.  Diet history  Daily fluid intake  History of surgery or illness affecting the GI tract.  Medication history  Emotional state.

8.
Assessment of the GITNursing History : Subjective Data1. General Data a. presence of dental prosthesis, comfort of usage b. difficulty eating or digesting food c. nausea or vomiting d. weight loss e. pain – may be caused by distention or sudden contraction of any part of the GIT - specify the area, describe the pain2. Specific data if symptoms are present a. situations or events that effect symptoms b. onset, possible cause, location, duration, character of symptoms c. relationship of specific foods, smoking or alcohol to severity of symptoms d. how the symptoms was managed before seeking medical help MTCAT 09

18.
UPPER GI SERIES (BARIUM SWALLOW)• Fluoroscopic examination of upper GI tract to determine structural problems and gastric emptying time.• Client must swallow barium sulfate• Sequential films taken as it moves through the system.Barium – is a radiopaque substance that when ingested or given by enema in solution, outlines the passage ways of the GIT for viewing by x-ray or fluoroscopy

20.
LOWER GI SERIES (BARIUM ENEMA)• Barium is instilled into the colon by enema• Client retains the contrast medium while x-rays are taken to identify structural

21.
Nursing care: pretest •NPO for 8 hours pretest •Give enemas until clear the morning of the test. •Administer laxative or suppository. •Explain that cramping may be experienced during procedure.Nursing care: posttest •Administer laxatives and

22.
ESOPHAGOGASTRODUODENOSCOPY (EGD) • Direct visualization of the esophagus, stomach, and duodenum by insertion of a lighted fiberscope. • Used to observe structures, ulcerations, inflammation, tumors; may include biopsy.

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 directly visualize the GIT by the use of a fiberscape fiberscope – has a thin, flexible shaft that can pass through and around bends in the GIT, transmit light and the image can be seen in the monitor

24.
ESOPHAGOGASTRODUODENOSCOPY (EGD) Nursing care: •NPO for 6-8 hours •Ensure consent form has been signed • Explain that a local anesthetic will be used to ease comfort and that speaking during the

36.
Common Causes of Constipation• Irregular bowel habits and ignoring the urge to defecate can cause constipation• Client who have a low-fiber diet high in animal fats and refined sugar often have constipation problems. Also low fluid intake slows peristalsis• Lengthy bed rest or lack of regular exercise causes constipation.• Heavy laxative use causes loss of normal defecation reflex. In addition, the lower colon is completely emptied, requiring a time to refill with bulk.• Tranquilizers, opiates, anticholinergics, and iron can cause constipation• Older adult experience slowed peristalsis, loss of abdominal muscle elasticity, and reduce intestinal mucous secretion. Older adults often live alone and eat low-fiber foods.• Constipation is also caused by GI abnormalities such as bowel obstruction, paralytic ileus, and diverticulitis• Neurological Conditions that block nerve impulses to the colon can cause constipation.

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Manifestation & Complications of Diarrhea• Increase in volume, frequency and consistency• Very large watery to very frequent small stools/ containing blood, mucus or exudate• Depends on the course, duration and severity• May result to vascular collapse and hypovolemic shock & hypokalemia

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DECREASING FLATULENCEOne method of treating flatulence involves the insertion of a rectal tube.Guidelines:• Use rectal tube (Fr 22-30) for adults and a smaller size for children.• Have the client assume a side-lying position.• Lubricate the rectal tube to reduce mucous membrane irritation.• Expose the anus and insert the rectal tube into the rectum 10cm (4in). The rectal tube will stimulate peristalsis. If no flatus is expelled, insert the tube another inch or so. Do not force the tube if it does not insert easily.• Wrap an abdominal or incontinence pad around the end of the rectal tube to catch any liquid that may be expelled. Or, placing the end of the tube into a receptacle filled with fluid.• Leave the tube in no longer than 3 minutes to avoid irritation of the rectal mucosa. If abdominal distention is not relieved, the tube may be inserted every 2 to 3 hours.• Encourage the client to assume various positions in bed.

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TEACHING ABOUT MEDICATIONS Cathartics and Laxatives  Cathartics are drugs that induce defecation. They can have strong, purgative effect. A laxative is mild in comparison to a cathartic, and it produces soft or liquid stools that are sometimes accompanied by abdominal cramps.  Cathartics: Castor oil, cascara, phenolphthalein and bisacodyl.  Laxatives are contraindicated in the client who has nausea, cramps. Colic, vomiting, or undiagnosed abdominal pain. Clients need to be informed about the dangers of laxative use.

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Critical Thinking Exercise Adam, 1 year old infant was Eve, 15 year old rider, was admitted in the hospital due to admitted in the hospital due to fever with temperature of 38 C, vehicular accident. She vomiting and diarrhea for 2 days reportedly loss herduration. The nurse reported that consciousness when she was the infant defecated 3 times as brought to ER thus upon many stool as usual with watery admission, she was placed consistency. Initially, it is initially on NPO. After a few apparent that the child is mildly days, on a balance skeletal dehydrated because of stool traction to treat fracture. She losses secondary to acute does not want to eat because infectious diarrhea. according to her, she lost her What appropriate nursing appetite every time she sees other patients. She had not care plans could you defecated also for 5 days formulate for Adam. already. Supplement necessary Formulate appropriate assessment findings nursing care plan for Eve.significant to the patient’s Supplement necessary case. assessment findings significant to the patient’s case.